Welcome to the Menopause Gold Rush

Entrepreneurs, as a result, have seen a business opportunity in creating an advocacy and visibility movement for menopause. Alisa Volkman, 49, who has twice greeted new phases of her life with an online start-up (the sex-positive nerve.com in her 20s, followed by the modern parenting hub babble.com) is now on to the Swell, an online membership community for the middle-aged.

In October, the Swell helped host a menopause symposium featuring Katie Couric and the comedian Jill Kargman. (“I loved being in a room with hundreds of women who could commiserate with my waking up in a Jill-shaped sweat stain, heart pounding like Roger Rabbit, and having to insert a tampon with a T-shirt cannon,” Ms. Kargman said.)

Like all new wellness categories (like sex toys, for instance, which are now marketed as self-care), it’s an investment category, for a group with specific, underserved needs — and a lot of money.

A ‘New Category’ of Health

The new menopause economy divides neatly along medical versus beauty lines.

The telemedicine start-ups deal largely in the prescribing of hormone replacement therapies, using a business model that has found success in other sectors. Hims & Hers Health, for example, which uses telemedicine to prescribe generic versions of Rogaine, Viagra and a range of antidepressants, birth control and other medications on gender-specific sites, has a market capitalization of more than $1 billion. The drugs the companies sell are generic versions of the name-brand formulations, and the company gets the profit. Subscription models are famously lucrative, as subscribers often fail to unsubscribe, even when a need has been met.

But H.R.T. is a complicated issue. After a large study in 2002, it was determined that the risks of H.R.T. were greater than the potential upsides. Further studies found that many of those concerns were overblown, or not applicable to populations who might benefit from hormone therapy, but many women and doctors were scared off and have stayed that way. According to Dr. Stephanie Faubion, a women’s health expert at Mayo Clinic and the medical director of the North American Menopause Society, the current official position is that the benefits of hormone therapy typically outweigh the risks for most healthy, symptomatic women under 60 and within 10 years of menopause onset. Dr. Faubion specified that it should be prescribed by a doctor educated in menopause management.

However, most OB/GYN residents get about one to two hours of instruction on menopause care and, when surveyed, said that they did not feel comfortable managing menopause upon completion of their programs.